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Alcohol and substance abuse, depression and suicide attempts after Roux-en-Y gastric bypass surgery.

https://arctichealth.org/en/permalink/ahliterature281902
Source
Br J Surg. 2016 Sep;103(10):1336-42
Publication Type
Article
Date
Sep-2016
Author
O. Backman
D. Stockeld
F. Rasmussen
E. Näslund
R. Marsk
Source
Br J Surg. 2016 Sep;103(10):1336-42
Date
Sep-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Alcohol-Related Disorders - diagnosis - epidemiology - etiology
Depression - diagnosis - epidemiology - etiology
Female
Follow-Up Studies
Gastric Bypass - psychology
Hospitalization - statistics & numerical data
Humans
Incidence
Male
Middle Aged
Obesity - psychology - surgery
Postoperative Complications - diagnosis - epidemiology - therapy
Registries
Substance-Related Disorders - diagnosis - epidemiology - etiology
Suicide, Attempted - statistics & numerical data
Sweden - epidemiology
Young Adult
Abstract
Small studies suggest that subjects who have undergone bariatric surgery are at increased risk of suicide, alcohol and substance use disorders. This population-based cohort study aimed to assess the incidence of treatment for alcohol and substance use disorders, depression and attempted suicide after primary Roux-en-Y gastric bypass (RYGB).
All patients who underwent primary RYGB in Sweden between 2001 and 2010 were included. Incidence of hospital admission for alcohol and substance use disorders, depression and suicide attempt was measured, along with the number of drugs prescribed. This cohort was compared with a large age-matched, non-obese reference cohort based on the Swedish population. Inpatient care and prescribed drugs registers were used.
Before RYGB surgery, women, but not men, were at higher risk of being diagnosed with alcohol and substance use disorder compared with the reference cohort. After surgery, this was the case for both sexes. The risk of being diagnosed and treated for depression remained raised after surgery. Suicide attempts were significantly increased after RYGB. The adjusted hazard ratio for attempted suicide in the RYGB cohort after surgery compared with the general non-obese population was 2·85 (95 per cent c.i. 2·40 to 3·39).
Patients who have undergone RYGB are at an increased risk of being diagnosed with alcohol and substance use, with an increased rate of attempted suicide compared with a non-obese general population cohort.
PubMed ID
27467694 View in PubMed
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Percutaneous endoscopic gastrostomy for nutrition in patients with oesophageal cancer.

https://arctichealth.org/en/permalink/ahliterature19299
Source
Eur J Surg. 2001 Nov;167(11):839-44
Publication Type
Article
Date
Nov-2001
Author
D. Stockeld
J. Fagerberg
L. Granström
L. Backman
Author Affiliation
Division of General Surgery, Karolinska Institute, Danderyd Hospital in Stockholm, Sweden.
Source
Eur J Surg. 2001 Nov;167(11):839-44
Date
Nov-2001
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Endoscopy, Gastrointestinal - adverse effects - methods
Enteral Nutrition - methods
Esophageal Neoplasms - therapy
Female
Gastrostomy - adverse effects - methods
Hospitals, Teaching
Humans
Male
Middle Aged
Retrospective Studies
Abstract
OBJECTIVE: To evaluate the technical aspects and risks of using percutaneous endoscopic gastrostomy (PEG) in the treatment of patients with oesophageal cancer. DESIGN: Retrospective study. SETTING: Teaching hospital, Sweden. SUBJECTS: 229 consecutive patients who presented with oesophageal cancer between January 1990 and the end of December 1999. INTERVENTION: Insertion of a PEG after diagnosis and before treatment. MAIN OUTCOME MEASURES: Morbidity and mortality. RESULTS: PEGs were successfully inserted in 222/229 (97%), and the tumour required dilatation in 103 (45%). There was 1 oesophageal perforation and 1 tear of the stomach wall, both of which resulted in death (mortality 0.9%). In 1 operated patient the right gastroepiploic artery was injured by the PEG, but this did not prevent the stomach being used successfully as the oesophageal substitute. PEGs were removed because of leaks in 2 patients. There was 1 possible implantation metastasis. CONCLUSION: PEG is a safe and a well tolerated way of ensuring enteral nutrition in patients with oesophageal cancer. The risk of the PEG complicating any later operation is minimal.
PubMed ID
11848238 View in PubMed
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A Swedish study of chemoradiation in squamous cell carcinoma of the esophagus.

https://arctichealth.org/en/permalink/ahliterature19496
Source
Acta Oncol. 2001;40(5):566-73
Publication Type
Article
Date
2001
Author
D. Stockeld
J. Tennvall
G. Wagenius
M. Albertsson
L. Backman
O. Brodin
M. Cwikiel
L. Granström
G. Gustafsson
S. Gustavsson
G. Hambraeus
R. Lewensohn
S. Sjöstedt
H. Strander
B. Aberg
J. Fagerberg
Author Affiliation
Department of Surgery, Danderyd Hospital, Stockholm, Sweden. stockeld@ebox.tninet.se
Source
Acta Oncol. 2001;40(5):566-73
Date
2001
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - adverse effects - therapeutic use
Carcinoma, Squamous Cell - drug therapy - mortality - radiotherapy - surgery - therapy
Chemotherapy, Adjuvant - adverse effects
Cisplatin - administration & dosage - adverse effects
Combined Modality Therapy
Disease-Free Survival
Dose Fractionation
Esophageal Neoplasms - drug therapy - mortality - radiotherapy - surgery - therapy
Esophagectomy
Female
Filgrastim - therapeutic use
Fluorouracil - administration & dosage - adverse effects
Gastrointestinal Diseases - etiology
Heart Diseases - chemically induced
Hematologic Diseases - drug therapy - etiology
Humans
Life tables
Male
Middle Aged
Radiotherapy, Adjuvant - adverse effects
Survival Analysis
Sweden - epidemiology
Treatment Outcome
Abstract
This multicenter study describes the development of a chemoradiation protocol for the treatment of non-metastatic squamous cell carcinoma of the esophagus. Eighty patients were treated with three courses of chemotherapy (cisplatinum and 5-fluorouracil) with concomitant radiotherapy (40 Gy) during the last two courses of chemotherapy. Esophagectomy was performed, when feasible. If no operation was performed, patients were planned to receive a target dose of 64 Gy. Toxicity was mainly attributable to hematological impairment and led to two adjustments of the treatment protocol (addition of filgrastim and lowering of the 5-fluorouracil dose). These changes made it possible to administer the planned treatment in a gradually higher proportion of patients (13/23 [57%] before changes of treatment compared with 30/36 [83%] after changes). Treatment-related mortality was 3.75% (3 patients, associated with leucopenic septicemia after chemotherapy). Fifty-four patients were resected. No per- or postoperative mortality was encountered. The complete response (pathological CR) rate in operated patients was 46% (27/59 patients) after chemoradiation. In the whole series the CR rate (including clinical CR for non-resected patients) was 44%. With a minimum follow-up of 37 months, the 3-year survival for the whole group was 31% compared with 57% for the CR patients. Total 5-year survival thus far (July 1999) is 26%.
PubMed ID
11669327 View in PubMed
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